Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

Abstract

The aim of the study was to evaluate bowel dysmotility in patients with a history of abdominal surgery by measuring both gastric transit time and small bowel transit time during capsule endoscopy and assessing the completeness of the examination. The study included 26 patients who had undergone abdominal surgery (postoperative group) and 52 patients who had not (control group). The capsule reached the cecum in 50.0% of the postoperative group and 80.8% of the control group (P=0.005). While there was no significant difference in gastric transit time between the two groups (P=0.882), small bowel transit time was significantly longer in the postoperative group (338.3+/-119.2 min) than in the control group (266.4+/-110.8 min, P=0.010). This is the first study to report that the small bowel transit time during capsule endoscopy is prolonged in patients who had a history of abdominal surgery, resulting in a lower frequency of complete examination.

Small Bowel Capsule Endoscopy Performance in Octogenarians: A Case-Control Study

“…Inaccordancewithotherreports,wefoundthatthemain reasonforincompleteSBexaminationistheprolongedcapsulestayinginatractproximaltothepylorus (7)(8)(9)(10)(11)(12)(13).Hospitalization, type 2 diabetes mellitus, and previous abdominal surgery are known conditions associated with incompleteSBexamination.Prokinetics(32)andchewing gum (33) prior to the procedure have been advocated to overcome these drawbacks, but there are no double-blind randomizedtrialstoprovetheireffectiveness,andarecent single-blindprospectivetrialofmetoclopramidewasdisappointing (34).Concerningtheotherriskfactors,ourcontrol group of younger patients was well matched not only for genderandclinicalindicationtoSBCEbutalsofordiabetes mellitus, previous abdominal surgery, and comorbidity, suggestingthatagingmaybeagenuineriskfactorforSBCE failure.…”

“…Ontheotherhand,CEisexpensiveanditsuseinclinical practicehastobeoptimized.Inparticular,foragoodyield oftheprocedure,twoissuesarecritical:theappropriateness ofclinicalindicationandtheexclusionofthosepatientscarryingahighriskoffailure.Althoughonlyfewstudiesaddressedtheriskfactorsforincompletesmallbowelcapsule endoscopy(SBCE),hospitalization,slowgastricemptying, previousabdominalsurgery,anddiabetesmellitusseemto berelatedtoapoorperformanceandalowerrateofcompleteness (6)(7)(8)(9)(10).Notsurprisingly,inasmallstudyofpatients with established chronic intestinal dysmotility, the completionrateofSBCEwasonly61% (11).Age,asavar-iableofSBCEperformance,hasbeenevaluatedintwostudies,withdifferentcriteriaandresults.Inthefirst,Fireman andco-workers (12),inaretrospectiveanalysisofalarge multicenter database, showed that people more than 40 yearsoldhavealongerSBtransittime;inthesecond,Papadopulos and co-workers (13) failed to demonstrate any significantdifferenceofSBtransittimeamongthreeagerelatedgroups(<40,40-65,and≥65)ofaprospectiveco-hortof120patients.…”

Route selection for double-balloon endoscopy, based on capsule transit time, in obscure gastrointestinal bleeding

“…Estimation using VCE transit time is effective, but advancing VCE speed can change due to the presence of obstacles or physiological changes causing obstructed bowel movement. Moreover, the speed of the VCE advance is considered to be affected easily by hospitalization or previous surgery of the abdomen [32][33][34]. Therefore, the route selection for DBE should be estimated by both the location of the lesion, detected by computed tomography (CT) or ultrasound sonography, and the distance from the mouth or anus to the lesion, as determined by VCE [35] or enteroclysis.…”

Effects of the Oral Administration of Mosapride Citrate on Capsule Endoscopy Completion Rate

“…Previous reports have suggested that GTT affects CE completion 2,5,13,14. Moreover, other factors, such as aging,15,16 diabetes mellitus,14 hospitalization,16 and previous abdominal surgery17 were found to be associated with incomplete CE. We confirmed that mosapride citrate administration and GTT less than 45 minutes were independent predictors of the CE examination completion according to a logistic regression model.…”